How can we get support for MIL and BIL living unsafely?

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TLDR: I’m looking for some advice and maybe some sign posting for help for support for my MIL (68) and BIL (45) who are living in a unsanitary, unsafe, disgusting condition.

It’s long to avoid drip feeding.

My MIL health isn’t great, her mobility is pretty much non existent, she sits in her chair all day and hardly moves, she doesn’t drink any water, only 4x Red Bulls per day and her diet comprises of high sugar. Her health has rapidly declined over the last 10 years. Every 18 months or so she’ll start to have falls and then get admitted to hospital for 2 weeks, starts to recover and the falls stop. Then the cycle will start again. She has got CKD3, Diabetes, Edema (the watery leg swelling thing) and she’s obese.

Her eldest son (my BIL) lives with her, he is unemployed (has been for 10 years), is super mobidly obese (definitely over 26 st, he’s 5ft 8). He has health problems too and is deeply unhygienic - hasn’t showered / washed since 2005.

we visited my MIL today and had to call 111 who called an ambulance. My MIL has been admitted to hospital again after a weeks worth of falls, plus she was slurring, drowsy and incoherent. BIL admitted that she’s been like this for over a week but only told us last night. We believe the cause is dehydration but will know more tomorrow. We could not have discovered this sooner as we live an hour away, work full time plus im 32 weeks pregnant and was blue lighted to hospital at the start of the week with significant bleeding which resulted in a 3 day hospital stay.

My husband is so unbelievably stressed. When we were at his mums house today before calling the ambulance we were deeply shocked at the state of the place. It’s not only unclean, it’s unsanitary. Like shit and piss all over the toilets - her ensuite stacked full of bagged soiled continence pads, it stank. You can’t see the floor in any room, my DH blocked me from entering the kitchen because it’s so disgusting he didn’t want me / his unborn child being exposed to it. DH attempted to clean the downstairs WC so I could use it but instead told me to ‘hold it’ and go to Tesco instead as it was too unsanitary in there.

We called the paramedics and one of them
was close to tears about the state of the house and how two people can live this way. They pulled me aside to get as much info as poss and said they’d raise a safe guarding concern.

My BIL mentioned that he’d been asking the neighbour to help him pick my MIL up off the floor when she had fallen in the week. I went and spoke with the neighbours and she said that she has been looking into how she can raise a safe guarding concern to see if MIL and BIL can get some support.

The issue is, MIL and BIL are both in huge denial about their situation. I don’t know why BIL doesn’t clean or tidy, he’s obese but can walk around and he is a massive contributor to the pigsty.

My MIL refuses to accept any help and will blame us now for her being admitted to hospital again. My DH and I are at a complete loss we don’t know who can help - it is not possible for us to go clean their house as we work full time and have our own house to clean, plus we live an hour away and are expecting our first child. And quite frankly - they are both adults with capacity and my MIL can afford a cleaner.

I guess I am looking for advice on if it’s possible to get someone round to inspect the place, assess both of them and make some recommendations. My MIL is super excited about the arrival of her first grandchild and I need to break it to her that absolutely under no circumstances will I be bringing a newborn to her house as it’s too disgusting and unsanitary there.

Yep, this.

Honestly having been through a very similar situation with my own Mum (who was abusive and awful) the more help they get from you / neighbours etc the less anyone else from the council etc will do. You have to step right back and just ring 999 when she needs help and let them deal with it.

If the fall out is awful then quite frankly that’s not your problem.

I would give them a hard line "we will not be returning until your house is clean - it is not safe for our baby". And give them the number for a cleaning company of the type that cleans crime scenes and hoarder situations. It's their choice to stay as they are or change, you can't force it.

In theory MIL should get Attendance Allowance and BIL should get ESA & PIP for his MH & Physical Health issues. Social services should be able to help or signpost to this.

I have experienced a not dissimilar situation, albeit it was with relatives in their 60s and 80s. It's very sad & stressful, but you can't really change them as others have said. In our case, eventually the MiL went into a care home & the son remained in the family home. Some time after (and MiL had died by this point) the son also had to go into a care home too - but he was in his 70s by this point.

I had a similar (but not quite as bad - no excrement) situation with a relative who lived about an hour away. He was in his 80s but was considered to still have capacity, which I saw just as the capacity to say no to all help offered even though it was not in his best interests to do so.

One of his neighbours was nice and checked on him a bit, while the other was really off with me and phoned me to say that he couldn't keep on like this. I know it must have been really difficult for them (his back garden was a jungle) but I had to ask her - what else could I do? I had phoned adult social services, his GP, the council - it all came to the same thing, if he doesn't agree, they can't do anything. One of them even said when I described his living conditions - well he's obviously not bothered why don't you just leave him be if he's happy?

I was at a dead end when his neighbour phoned me saying she hadn't seen him for a few days, I asked the police to do a welfare check and he was found dead in his armchair with the TV on.

It felt as though I was just batted from person to person, tried to put things in place and then he would just scupper them.

These are all their own choices OP, and sometimes you just have to walk away to save your own sanity. They both have capacity, both know that their diets are killing them yet they carry on and choose to live in utter filth. I used to work in care, and had several clients that you had to get changed after you'd been in their houses. Desperate relatives had got SS/GP/MH teams involved but they can't force someone to be tidy or eat well if they are deemed to have capacity.

Let your DH see them as and when he can, but stay well away especially with your baby. Focus on your own family.

He can't claim ESA if he hasn't worked in recent years. Maybe UC depending whether he has savings.

What difference will this make though? Because then they just wreck wherever they move to next ...!

There is nothing you can do about it. They are adults with full capacity. If they want to live like that then they can. I personally would refuse to visit on unsanitary grounds.

Same here. I've seen multiple clients living in absolute filth in homes with overgrown gardens and no central heating, many elderly. They have hundreds of thousands in the bank and multiple services offering to help them get help in place yet they refuse. Baffling but not uncommon.

People in these states I tend to think must have mental health issues - depression of a sort

and as such there is nothing that you can do if they don’t want to change

and it’s heartbreaking

The sad thing is doing a big deep clean, even then arranging regular cleans on top rarely works if the person doesn’t want to change. The hoarding and self neglect just builds up again and they remain isolated, they can’t see what they are missing in terms of a good relationship with you/grandkids, a full life. It does seem to be a mental problem first, social services can only override wishes and step in to provide care/accommodation when health has deteriorated alongside/there’s a clear cognitive impairment.
Great to flag with GP, some areas have better support available for people with hoarding/squalor than others.
Falls alarm linked to call centre could be a good idea, you can arrange this privately or ask social services to signpost you to a good provider. If they agree to it.
it’s good your DH isn’t too sucked into this but must be very distressing for you all. Keep your boundaries in place if what you can tolerate in walking alongside them with this.

They are hazards to themselves and each other

However, if BiL will be the hospital's only contact, both he and MIL are in denial and they are both deemed as having capacity, then this revolving door to hospital and home will carry on

Document with photos everything - the soiled incontinence pads, the state of every room in the house, the garden, the diet etc

Try to involve their GP/GPs as well

The discharge team at the hospital must be informed as well - they've got to see what your MIL will be discharged back to

Environmental Health need to be informed as what your describing is a hazard to occupants and will more than likely attract vermin

Does your BiL have any diagnosis - gambling, binge eating, alcoholism, autism - anything at all to explain his behaviour in all this

Unfortunately, stressed or not, your husband needs to step in and start informing social services, environmental health, the GPs and the discharge team as he seems to be the only other family member

The dynamics between BIL and MIL is incredibly toxic. BIL doesn’t have any formal autism diagnosis. They are codependent on one another, MIL has ‘tried’ to address BILs behaviour and attitude but he just sulks. DH and I believe BIL is somewhere on the spectrum but TBH we both see that he is lazy and manipulative. For example - BIL has convinced MIL that the reason he can’t get a job is because all jobs are going to 16 year olds because companies can pay them less. MIL believes this and refuses to see that the reason BIL can’t get a job is because he is like a walking version of Jabba the Hutt.

The two of them live like a married couple and do everything together, food shopping, appointments etc. MIL lived like this with her own dad before he died (20 years ago) and it appears that BIL has stepped into the role. DH lived with them until he was 30 when we then moved in together. Their house would not be in this state of DH still lived with them. DH is clean and their house was clean/tidy when DH, BIL & MIL all lived together.

We just got back from the hospital, MILs health is worse than originally thought. She has respiratory failure and is in majors. Her falls this week are likely to do with her low oxygen and her briefly blacking out. BIL said he doesn’t believe this and thinks her falls are because the house is a dump and she’s tripped over shit. Either way, when we saw her yesterday it was shocking because she was slurring like she was drunk or something which is why we called 111. MIL thinks she’s going to be discharged tomorrow :-/

I think BIL is out of his depth, plus in huge denial about her health. He knows that ultimately he cannot afford to live without her. She pays for everything and he gets basic benefits. I don’t know how much benefits he gets, all I know is the job centre send him to the odd interview every few months.

MIL owns her house outright. BIL lives there rent free - in fact, she gives him money every month (approx £600). I doubt he has savings, BIL collects retro games and Pokémon cards. He was a chain smoker up until 12 months ago (funded by MIL) but has now quit. I think deep down BIL is scared because he knows if MIL dies, the house will be sold because he simply cannot afford to live there.

Sorry I am waffling now and I don’t know if this information if even relevant but I just wanted to add some more context to their complex situation. And it’s been a very stressful week with my own pregnancy / hospital scare (I’m not out the woods yet).

I think most PPs are right, all we can do is report to the different services, speak to the discharge team and try detach emotionally as they are adults with capacity.

Also I agree with the neighbours not helping pick MIL up when she falls. The teenage daughter and her friend had to do it a few days ago. BIL knocked their at midnight?!?! I was fuming when neighbour told me this.

See this in itself leads me to believe the BIL must have some sort of MH disorder, learning disability or the likes.
People wouldn't knock on a neighbours door that late, they just wouldn't. So the fact he did really indicates his lack of awareness ..or a relcutance to get professionals involved

Or it just indicates he is inherently selfish and does what he wants and expects others to clean up around him.

BIL is Definitely reluctant to get help because MIL acts like a sulky child when anyone tries to help. The first thing she said to me when I just visited at the hospital was ‘this is all your fault’. Thankfully the doctor then put the NIV/EP mask thing back on back on her which prevented her from speaking - DH would’ve been so upset if he heard her say that to me.

I think you’re right with this! He knows where his bread is buttered and I think this is why he’s not been entirely honest about her health. He cannot afford for her to die/get taken into a care home. BIL still believes that MILs health is ‘normal’… he’s downplaying it, he’s out of his depth.

Contact SS to take the weight off your shoulders but I don’t think they will do much.
I would take a step back and suggest your husband puts him and the family he has built first and do some therapy. It’s not a normal situation he’s been having to deal with.
Finally under no circumstances would I allow yourselves to be guilted into bringing your new baby to their home.

I think you’re right. We have our own stuff going on - we were told on Thursday that because I have had two significant bleeds during pregnancy and this could happen again, there’s a high possibility of baby being premature 😭

I’ve made it clear to DH that baby will not be going to MILs house unless they have a regular cleaner in place but that’s a conversation for her if/when she gets home.

As a nurse I can second that ..."unsafe discharge"
are definitely the words no ward likes to hear as it will come back on them!

Ok so if sadly Mil does die, he will inherit half of the house and may have enough to buy a small flat or something or will have to rent and live off the inheritance until benefits kick in again.

But it's BIL's home too. Noone can make him move out if MIL has to go into a home. Have you seen MIL's will also??

Only if he owns it, maybe part owned with MIL or she leaves all of it to him in her will.

If she goes into care he can only carry on living there if he’s over 60 (which he’s not) or under 60 and with a disability, which it sounds like he has but without a diagnosis?
https://www.ageuk.org.uk/information-advice/care/paying-for-care/paying-for-a-care-home/do-i-have-to-sell-my-home-to-pay-for-care/

Jabba the Hut has really made me laugh..! Sorry!!

Congratulations on your pregnancy though. Definitely try to relax, you need to put yours and baby's wellbeing first